MedMicro 2006 UTHSCmed
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| Enterobacteriacaea (ALL) | Gram (-)
Catalase (+)
Oxidase (-)
Ferment Glucose
MacConkey Agar
bacillus(rods)
non-spore forming
facultative anaerobe
nitrate reducers
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| opppurtunistic pothogens (E. coli, Klebsiella) | normal flora but wrong location (or overabundance)
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| frank pathogens (Salmonella, Shigella) | presence in any amount is considered indicative of disease
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| not good in lower respiratory tract | klebsiella, Enterobacter, E. coli
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| not good in blood stream | ANYTHING
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| not good in GI Tract | Salmonella, Shigella, Yersinia
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| not good in Urinary Tract | Escherichia, Klebsiella
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| Escherichia | UTI, gastroenteritis, meningitis, septicemia, hemorrhagic colitis (EHEC)
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| Shigella | Bacillary dysentery
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| Salmonella | Gastroenteritis, septicemia, enteric fevers(typhoid)
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| Klebsiella | Pneumonia, UTI
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| Yersinia | Gastroenteritis, plague, zoonotic infections
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| Serotyping | identification of surface antigens of isolates
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| 3 types of antigens most commonly encountered when serotyping | O=somatic cell wall antigens, H = flagellar antigens, K = capsular antigens
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| MacConkey Agar (Isolation Media) | divides into coliform(lactore fermentors) and non-coliform(noo-lactose fermeters), inhibits gram (+)
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| coliform | E. coli, Klebsiella
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| non-coliform | Salmonella and Shigella
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| coliform bacteria | indictor of water contamination
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| Virulaence factors | Lipip A portion of O antigen (endotoxin), Many have capsule, Phase variation, Exotoxins, Adhesion Factors, Growth Factors, Resistance to Serum, Ab resistance plasmids
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| Exotoxins | Enterotoxins and Cytotoxins
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| Enterotoxin | Heat labile(increases cAMP) and Heat Stable (increases cGMP)
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| Cytotoxins | Shiga toxin(neurotoxic inhibits 60s) and Hemolysins (lysis RBCs free iron)
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| Adhesion Factors | P finbriae = uropathogenesis, s = neonatal Sepsis and meningitis
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| Escherichia coli (E. coli) | most predominate facultative anaerobe normal flora member of Intestinal tract
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| E. coli extra-intestinal infections | UTI, septicemia, neonatal menigitis
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| Intestinal infections(E. coli) | Enteroinvasive(EIEC), Enterotoxigenic (ETEC), Enterohemmorrhagic (EHEC), Enteropathogenic (EPEC), Enteroaggregative (EAECor EaggEC)
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| enteroinvasive(EIEC) | destroys colonic epithelim, becomsed intracellular parasite, Shigellla-like (clinically indistinquishable)
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| enterotoxigenic(ETEC) | makes heat stable and heat labile, major cause of traveller's diarrhea
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| enterohemorrhagic(EHEC) | verotoxin(shiga-like), bloody diarrhea, hemolytic uremic syndrome(HUS)=acute renal failure, serotyping necessary
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| enteropathogenic(EPEC) | nursery outbreaks, secreted factors enhance colonization
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| enteroaggregative (EAEC) | prolonged watery diarrhea, adherence is main virulence factor, common in developing countries
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| invasive organisms | EIEC and shigella
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| adherent organisms | ETEC, EPEC, EAEC
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| penetrent | Salmonella
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| SI infection | ETEC, EPEC, Salmonella
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| LI infection | EIEC, EHEC, Shigella
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| Shigella (dysenteriae, flexneri, boydii, sonnei) | NON-motile, and DO NOT produce gas
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| Mucosal ulcerations, Humans and primates only hosts, Fecal-Oral transmission | Shigella
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| Shigella Diagnosis | Dysentery in 1-4 days, sudden onset of Ab cramps, Diarrhea, fever, blood and mucus in stool, Isolation in SELECTIVE media to confirm
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| Salmonella (typhi, choleraisius, enteritidis) | non fermeter of lactose or sucrose, does produce gas (H2S), not a coliform
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| S. typhi (typhoid fever) | 7-14 day incubation, malaise, anorexia, headache, fever
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| Salmonella (gastroenteritis) | 8-48 hours afrter eating infected food, meats and poultry, initially headache, chills, ab pain, followed by nausea diarhea, vomiting and fever
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| Diagnosis for salmonella | from stool/blood, Widal test for specific aglutinins
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| salmonella treatments | typhoid and septicemia (chloramphenicol w/amp or trimethoprim-sulfomethoxazole)
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| Salmonella Tx duration | at least 2 weeks to avoid relapse due to ability ot survive inside phogocytes
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| gastroenteritis Tx | no antibiotics (will prolong carrier state), Self-limiting
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| Klebsiella | non-motile, encapsulated, lactose fermenter
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| Main virulence factor (Klebsiella) | capsule which inhibits phagocytosis
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| Yersinia (pestis, enterocolitica, pseudotuberculosis) | mainly animal pathogens, but can cause severe disease
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| Y. pestis | Black Plague
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| Y. pseudotuberculosis | pseudo appendicitis, lesions...self-limiting
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| Y. enterocolitica | enterocolitis(primarily), fever, diarrhea, ab pain ...self-limiting
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